Hip Arthroplasty in Mentally Impaired Patients

Ries,; Wolff, Dylan T.; Ja, Shaul

doi:10.1097/00003086-199411000-00021

Cited by 21 publications

(16 citation statements)

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“…As to schizophrenia and its association with more in-hospital adverse events, analogous findings were reported in hip arthroplasty [33] and general surgery procedures [7]. It is possible that social isolation and communication difficulties could contribute to adverse events in patients with schizophrenia.…”

Section: Discussionmentioning

confidence: 64%

Do Psychiatric Comorbidities Influence Inpatient Death, Adverse Events, and Discharge After Lower Extremity Fractures?

Menendez

Neuhaus

Bot

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Psychiatric comorbidity is known to contribute to illness (the state of feeling unwell/unable to rely on one's body) and increased use of healthcare resources, but the effect on inpatient outcomes in fracture care is relatively unexplored. Questions/purposes Our primary null hypothesis is that a concomitant diagnosis of depression, anxiety, dementia, or schizophrenia is not associated with (1) discharge to another care facility rather than home after lower extremity fractures. Secondary study questions address the associations between psychiatric comorbidity and (2) longer inpatient stay and inpatient (3) adverse events; (4) blood transfusion; and (5) mortality after lower extremity fractures. Methods Using the National Hospital Discharge Survey database, we analyzed a total estimated number of 10,669,449 patients with lower limb fractures from 1990 to 2007. Sixty-four percent were women, and the mean ± SD age was 67 ± 22 years. The prevalence in the study population was 3.2% for depression, 1.6% for anxiety, 0.6% for schizophrenia, and 2.9% for dementia. Results A discharge diagnosis of psychiatric comorbidity was associated with a lower rate of discharge to home after accounting for an association with greater medical comorbidity (schizophrenia: odds ratio [OR], 5.6, 95% confidence interval [CI], 5.5-5.8; dementia: OR, 1.3, 95% CI, 1.2-1.3; depression: OR, 1.2, 95% CI, 1.2-1.3; anxiety: OR, 1.04, 95% CI, 1.02-1.06). Hospital stay was longer for patients with schizophrenia and dementia but shorter in patients with depression or anxiety compared with patients without any mental disorders. Schizophrenia was associated with more in-hospital adverse events and depression and anxiety with fewer events. A diagnosis of depression was associated with blood transfusion. Psychiatric comorbidity was not associated with a higher risk of in-hospital death.

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Section: Discussionmentioning

confidence: 64%

Do Psychiatric Comorbidities Influence Inpatient Death, Adverse Events, and Discharge After Lower Extremity Fractures?

Menendez

Neuhaus

Bot

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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“…Because THA has been so successful for pain relief and restoration of function in the general population, the senior author (LR) began performing THA in patients with CP in 1971. Because there have been little data regarding the long-term benefits of THA in this population, there has been reluctance to perform THA in patients with CP for fear of dislocations or premature prosthetic loosening and increased perioperative complications [34]. The purpose of this retrospective study is to evaluate the results of the following parameters of THA for painful hips in patients with CP: (1) pain relief;…”

Section: Discussionmentioning

confidence: 99%

“…Although THA offers the best option for pain relief and conservation of motion, there have been concerns regarding the possibility of dislocation and component loosening, especially when performed in young adults or the mentally impaired [7,13,32,34]. With advances in technique and prosthesis design, hip arthroplasty in patients younger than 50 years is becoming an accepted practice in the general population [26,44].…”

Section: Introductionmentioning

confidence: 99%

“…With advances in technique and prosthesis design, hip arthroplasty in patients younger than 50 years is becoming an accepted practice in the general population [26,44]. Hip arthroplasty in patients with CP is not widely reported [3,5,34,37,45]. Prior studies have used end points that can be assessed easily: pain relief, survivorship, and functional level [5,37].…”

Section: Introductionmentioning

confidence: 99%

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Long-term Followup of Total Hip Arthroplasty in Patients with Cerebral Palsy

Raphael

Dines

Akerman

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…There is only limited data on hip arthroplasty in cerebral palsy in the literature. Patient groupings are often inconsistent and include neuromuscularly impaired patients with mental retardation, Down syndrome, schizophrenic patients and patients with cerebral palsy [15,19]. Different groups have reported experience with total hip replacement in nonambulatory patients and ambulatory patients with cerebral palsy [8,16,18].…”

Section: Discussionmentioning

confidence: 99%

Long-term results of hip arthroplasty in ambulatory patients with cerebral palsy

Schroeder

Hauck

Wiedenhöfer

et al. 2009

International Orthopaedics (SICOT)

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Osteoarthritis (OA) secondary to dislocation and dysplasia is a common problem in patients with cerebral palsy. The purpose of this study was to evaluate the results of total hip replacement (THR) in ambulatory patients with cerebral palsy. Eighteen total hip arthroplasties were performed in 16 ambulatory patients with cerebral palsy. The patient's mean age at surgery was 42±8 years (range 32-58 years), and the mean follow-up was 10±6 years (range 2-18 years). Data were obtained by a standardised telephone interview. There was a significant postoperative reduction in pain on the NAS (narrative analogue scale) from 8.4 preoperatively to 1.1 postoperatively (p= 0.002). At follow-up no stem had been revised. Three cups were revised for aseptic loosening at two and six years, and one cup was revised for recurrent dislocation of the hip. One hip was revised for infection 12 years after the index surgery. One hip dislocated (three months postoperatively) and was treated by closed reduction. In ambulatory patients with cerebral palsy and secondary osteoarthritis of the hip THR can provide long-term pain relief and improved function. The rate of long term complications was moderate in this series; however, the dislocation rate was higher than in standard OA cases.

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Hip Arthroplasty in Mentally Impaired Patients

Cited by 21 publications

References 0 publications

Do Psychiatric Comorbidities Influence Inpatient Death, Adverse Events, and Discharge After Lower Extremity Fractures?

Do Psychiatric Comorbidities Influence Inpatient Death, Adverse Events, and Discharge After Lower Extremity Fractures?

Long-term Followup of Total Hip Arthroplasty in Patients with Cerebral Palsy

Long-term results of hip arthroplasty in ambulatory patients with cerebral palsy

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